Coxarthrosis (osteoarthritis of the hip joint) is a degenerative-dystrophic disease of the hip joints, accompanied by damage to the articular cartilage, bone tissue and periarticular structures and leads to permanent loss of joint function.
Osteoarthritis of the hip joints is one of the most severe dystrophic pathologies of the musculoskeletal system with the help of money. The disease quickly leads to a decrease in physical activity, changes in the nature of a person's movements, often - to the inability to move independently and disability. A few decades earlier, coxarthrosis was considered one of the "diseases of old age", but since the beginning of this century, a high incidence has been recorded among young and middle-aged patients, which is related to various reasons.
Statistics
Osteoarthritis is the most common pathology of the musculoskeletal system and occurs in 70% of adults; coxarthrosis - in 25% of patients with orthopedic profile. Up to 30% of patients diagnosed with coxarthrosis are disabled, receive a disability, and require joint replacement surgery.
The disease occurs from 20-25 years, the average age of onset of symptoms is 37-39 years, progresses with age, which is associated with the presence of concomitant pathologies of the musculoskeletal system, bone loss, etc. In middle-aged patients, the prevalence of coxarthrosis is 11%, in people older than 85 years - 35%. In children and adolescents, coxarthrosis is a consequence of congenital joint dysplasia, which is observed in 1% of newborns.
Reasons for development
The reasons that lead to the development of osteoarthritis of the hip joint have different meanings depending on the age and general health of each patient:
- congenital disorder of normal anatomical shape of joints - femoral neck deformities, congenital hip dislocations;
- deformation of the femoral head due to degenerative (age) processes in the joint;
- traumatic injuries - fractures, sprains, non-physiological, including sports, loads on the joints;
- infectious and inflammatory diseases - tuberculosis, osteomyelitis and others;
- rheumatoid arthritis and other systemic diseases (allergic, metabolic);
- if the exact cause of the disease has not been determined and if it has developed on its own, the term "idiopathic coxarthrosis" is used.
Symptoms of hip coxarthrosis
Pain is the main symptom. Their severity and the addition of other manifestations of coxarthrosis depends on many factors, especially on body weight, lifestyle, age. In the initial stage, patients notice moderate, intermittent pain in the hip joints, which occurs mainly during physical exertion and passes on its own. Then the pain begins with light loads, does not pass at rest, "shoots" in the knee joint. The mobility of the joint or both joints is limited.
Patients are forced to limit physical activity, lameness, "duck walk" occurs. In the final phase, painful constant pains are noticed, the mobility of the hip joints is severely limited, walking is possible only with a cane or crutches, patients need day and night help, they are disabled.
Development
As the disease progresses, the hip joint gradually collapses and completely loses its function.
There is thinning of the articular cartilage and a slight narrowing of the joint space. The bone tissue located below the cartilage becomes denser. At this stage, the pain appears after exercise.
In the second stage, the destruction of cartilage progresses. Marginal osteophytes - growths on the bones - appear. The narrowing of the joint space progresses. Pain occurs when walking, limitation of joint mobility (contracture).
In the final stage of coxarthrosis, the growths on the bones are extensive, there is a flattening and subluxation of the femoral head, the joint space practically disappears. Constant severe pain, joint mobility is significantly limited.
Diagnosis of coxarthrosis
If you feel pain in the groin area, limited joint mobility and other symptoms listed above, you can consult a therapist, but the leading medical specialist who diagnoses and treats hip osteoarthritis is an orthopedic traumatologist.
The main method for diagnosing coxarthrosis is radiography. This is an informative method that allows you to accurately assess structural changes in the affected joints. Due to its cost-effectiveness and affordability, joint radiography is still very widely used. X-ray computed tomography is a more informative (but expensive) method. Magnetic resonance imaging (MRI) of the joints is also used. It is performed for the detection of coxarthrosis in the pre-X-ray phase (when there are no changes in the X-rays), as well as for the differential diagnosis.
Treatment of hip joint coxarthrosis
In the early stages of coxarthrosis, with a favorable course of the disease, conservative methods using physiotherapy techniques are preferred, including kinesiotherapy, massage and physiotherapy, especially water and mud therapy, physiotherapy complex. Among the physiotherapeutic techniques that have proven to be good, magnetotherapy can also be distinguished.
Magnetic therapy for coxarthrosis is used for various purposes. Under the influence of the magnetic field in the body, regeneration processes are activated, including in the bone tissue, and blood circulation improves. The last point is especially important, because in osteoarthritis there is an insufficient supply of blood to the joints, and thus a lack of nutrients to maintain the normal state of cartilage and bone tissue, and this can exacerbate pathological changes in the joint. Improving blood circulation in the hip joints helps to restore the flow of necessary nutrients to the joints, activates metabolism in bone and cartilage tissue, which is the basis for the positive effect of magnetotherapy in coxarthrosis.
Also, due to the intensification of metabolic processes and the release of certain biologically active substances, the anti-inflammatory and analgesic effect of magnetotherapy is observed.
Diet therapy is recommended to normalize metabolism and reduce body weight. In addition to a rational diet, it is possible to use auxiliary drugs (drugs and biologically active pharmaceutical supplements) that affect metabolic and recovery in the musculoskeletal system - based on glucosamine and chondroitin (chondroprotectors), minerals and vitamins, standardized plant extracts.
Drugs with anesthetic and anti-inflammatory effect, namely NSAIDs, GCS, muscle relaxants and some others, are used in all stages of coxarthrosis to relieve pain and inflammation. Their use should be strictly dosed, under supervision and according to the doctor's instructions.
In the second or third stage of the disease, depending on the symptoms and condition of the patient, it is recommended to continue conservative treatment or surgery. Currently, various surgical methods are used, the best results (complete restoration of joint function and human mobility) are achieved by total arthroplasty - hip replacement.
Drug therapy, diet and lifestyle changes, physiotherapy and spa treatments are also recommended, both in the case of surgery and in a conservative approach. Physiotherapy techniques in complex treatment can reduce the amount of medication and the load on the body, promote faster recovery after surgery and improve the general condition of the patient. Magnetotherapy especially shows good efficiency and tolerance, even in debilitated elderly patients and people with chronic diseases of the nervous and cardiovascular system.
Prevention of hip arthrosis
As a preventative measure, early detection of coxarthrosis at an early stage is very important. If you find symptoms (pain, limited mobility) in the area of the hip joints, you should consult a doctor - you can visit a therapist first, and then an orthopedic surgeon. The therapist may prescribe initial pain treatment, recommend chondroprotectors, and the orthopedist will prescribe special treatment.
Absence of overweight and normal physical activity, correction of working conditions and lifestyle in general, as well as timely treatment of diseases that can become one of the causes of coxarthrosis (inflammatory, infectious diseases of the joints, congenital anatomical defects of the joints, degenerative dystrophic diseases).